Related Experiment Videos
Low-dose amiodarone for atrial fibrillation
H R Middlekauff1, I Wiener, W G Stevenson
1Division of Cardiology, University of California, Los Angeles School of Medicine 90024.
The American Journal of Cardiology
|November 26, 1993
Summary
Low-dose amiodarone effectively suppresses atrial fibrillation, showing promise for heart failure patients. While side effects occur, they are often reversible, and proarrhythmia risk is minimal.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Class I antiarrhythmic drugs face scrutiny for proarrhythmia and inefficacy.
- Low-dose amiodarone (200-400 mg/day) is being reconsidered for atrial fibrillation suppression.
Purpose of the Study:
- To evaluate the efficacy and safety of low-dose amiodarone for atrial fibrillation management.
- To assess amiodarone's role in patients with refractory atrial fibrillation and congestive heart failure.
Main Methods:
- Review of nonrandomized trials assessing amiodarone for atrial fibrillation.
- Analysis of reported efficacy rates, side effect profiles, and proarrhythmia risk.
Main Results:
- Amiodarone maintained sinus rhythm in 53-79% of patients in nonrandomized trials.
- Intolerable side effects (e.g., pulmonary toxicity) occurred at 1-12% per year but were mostly reversible.
- Proarrhythmia risk was notably low, even in patients with left ventricular dysfunction and heart failure.
Conclusions:
- Low-dose amiodarone is a viable option for atrial fibrillation suppression, particularly in heart failure patients.
- Further randomized trials are necessary to compare amiodarone against conventional therapies and warfarin for thromboembolism prevention.